What are the responsibilities and job description for the Senior Clinical Coding & Appeals Specialist (RN / CPC / CCS) position at PromptWrx?
Help Build the Future of Healthcare Revenue Recovery
PromptWrx is transforming how healthcare organizations manage revenue cycle. Our AI-powered platform helps providers reduce denials, recover underpayments, automate appeals, and improve financial performance across the revenue cycle.
We’re looking for an experienced Clinical Coding & Appeals Specialist who combines clinical judgment, coding expertise, and payer knowledge to help shape the next generation of intelligent automation.
This is not a traditional back-office coding role. Your expertise will directly influence technology used by hospitals and provider organizations at scale.
What you’ll do
- Review medical records, physician documentation, and clinical data to validate coding accuracy and medical necessity.
- Apply expert knowledge of ICD-10, CPT, HCPCS, DRG/APR-DRG methodologies.
- Lead denial prevention and appeals efforts for coding, clinical validation, authorization, and medical necessity denials.
- Draft, review, and optimize appeal letters using documentation, payer policy, and reimbursement logic.
- Identify denial trends, root causes, and opportunities for workflow improvement.
- Partner with product, engineering, and operations teams to translate subject matter expertise into AI workflows and product requirements.
- Help train and validate AI systems to replicate high-quality coding and appeals decisions.
- Serve as an internal subject matter expert for coding compliance, reimbursement logic, and payer behavior.
What we’re looking for
- One of the following credentials: CPC, CCS, CCS-P, RHIA, RHIT, or equivalent.
- 5 years of healthcare revenue cycle experience with strong focus on coding, denials, appeals, or utilization review.
- Deep understanding of payer policies, CMS guidelines, and reimbursement processes.
- Proven success overturning denials through documentation and appeals strategy.
- Strong written communication skills with ability to draft persuasive clinical appeals.
- Experience working in EHR/RCM systems such as Epic, Cerner, Meditech, Athena, Availity, Optum, or similar.
- Active RN license or prior clinical nursing experience.
- Hospital acute care background.
- Experience with Medicare, Medicaid, and managed care plans.
- Startup or high-growth company experience.
- Interest in AI, automation, and healthcare innovation.
Why join us?
- Build technology that solves real healthcare payment problems.
- See your expertise embedded into scalable AI products.
- Join an experienced leadership team spanning healthcare, engineering, and operations.
- Work in a fast-moving environment where your ideas matter.
- Help providers recover millions in earned revenue while reducing unnecessary patient burden.
If that’s you … let’s talk -> careers@promptwrx.com